The ultimate goal of healthcare services in the US is to ensure that all individuals receive the highest quality of care at the most affordable costs possible. Equality in access is also exceedingly important because the availability of services plays a defining role in whether patients will receive the care they need. However, the modern healthcare environment is characterized by increasing healthcare costs, rising numbers of uninsured citizens, and inconsistencies in the quality of care provided to patients. This calls for a drastic reconsideration of the way in which health care is being carried out as well as the costs that patients spend. Aligning quality of care with compensation is among the key goals in terms of reaching affordable, accessible, and effective care for American citizens.
The article “American health care since 1994: the unacceptable status quo” by Furnas for Center for American Progress looks back on the development of the American health care system, with the focus placed on the implications of the 1994 failed reform. The author underlines the importance of reassessing the processes involved in care delivery and changing the flawed system for the better through cutting costs and increasing quality.
Since the mid-90s, the cost per patient in health care has increased by more than 100%, with the annual growth rates rise more than twice compared to inflation. Linked to the increasing costs of prescription medicine, ineffective outpatient care, unnecessary medical procedures, and exceedingly ballooning costs of insurance, the prices of healthcare have put a significant burden on the financial prosperity of citizens.
According to the article by Furnas, the increasing costs of health care also put a strain on American employers who had to decrease their expenditures on providing coverage to their employees. Importantly, healthcare premiums for the health care provided by employers have doubled since 2000, with the average family premium being as high as $6,800. In 2008, the same premium reached $12,700, which points to the disproportionate rise in healthcare costs that led to many firms reducing their coverage due to limited affordability. With the decreased opportunities to receive employer-paid healthcare coverage, Americans struggle with finding ways of finding insurance in the unregulated private market, which is why many become uninsured.
Consequently, families are faced with high premiums and deductibles as well as co-pays, which limit their financial prosperity and the capacity to pay for emergency care when needed. As mentioned by the author, between 2000 and 2001, 11% of American families spent 10% or more of what they earn on out-of-pocket healthcare, which is an increase from 8% in 1996-1997.
Disparities in spending have also been found in terms of comparing the US to other developed economies. It was found that the US spent $650 billion more on healthcare services than peer countries after the wealth adjustment. Furthermore, Americans were found to spend twice as much on health care as the OECD median. These findings point not only to the fact that individual citizens struggle financially but also that the fiscal health of the country is suffering.
The rate at which the spending on health care grows relative to the economy is an essential determinant of the long-term budgetary balance of the country. The trend of increases in health care expenditure was expected to continue, with the rising burden on states and their citizens individually. It is also important to note that the increasing costs of healthcare are a result of not only population growth or changes to healthcare policies but also the underlying lack of efficiency and the use of the expenses within the system overall.
Vanishing coverage and declining quality of services are the two fundamental limitations to building a high level of efficiency within the healthcare system. The rising numbers of American citizens who do cannot afford health insurance mean that they have to pay out of their pockets for health care services they receive. By the time when the article was published, there were an underestimated 25 million underinsured adults in the United States.
This meant that health coverage was inadequate for protecting the public from paying high medical costs. Therefore, Americans went without needed care, which inevitably increased the total expenses spent on health care. The uninsured had to pay the most overall as hospital stays, and last-minute emergency services were the most expensive. According to the 2005 study, by 2010, families would have paid $1,500 in insurance premiums as related to the need to cover the expenses that were not compensated to them.
When it comes to the declining quality of services, they also contribute to the rising health care expenditures starting from 1994. The findings of a Commonwealth Fund study showed that the US got a score of 65 out of 100 when comparing the national averages with those achieved internationally. This meant that the country was performing worse in terms of health, efficiency, and the overall quality of services.
The increased infant mortality is among the indicators of declining quality of care. As mentioned by Furnas, in 1994, the US rate was 0.8 death below the 8.8 OECD average. However, by 2004, the rate increased to more than one death above the OECD average, with per-person expenditures increasing. The same trend applies to life expectancy and birth. Despite the fact that the US spends more on health care each year, the high expenses are not enough to ensure that the country reaches the desired levels of life expectancy, child mortality, and births.
The growing rates of such chronic conditions as obesity and type 2 diabetes also point to the lack of effectiveness of the services that healthcare institutions provide to their patients. For example, in 1995, the rate of obesity among adults was 16%, while in 2007 it increased to 26.3%. The rise in obesity rates points to the fact that the healthcare system has been failing to implement effective disease management and preventive care as national priorities for comprehensive public reforms. Instead, healthcare facilities have been focused on ensuring that they receive enough financial support in order to care for patients at an average level.
Therefore, going forward, more attention should be placed on the quality aspect of care as it is also concerned with prevention and management efforts, and not only the addressing of acute health care issues that require an immediate response. Overall, the findings of the article point to the maintenance of the status quo associated with spending more money to cover fewer people, thus receiving unsatisfactory outcomes. The status quo should be challenged, with healthcare institutions focusing on the quality of care that they provide to the population.